Hickson M, Fearnley L, Thomas J, Evans S
Dietetic Research Group, Hammersmith Hospitals NHS Trust, London, UK.
J Hum Nutr Diet. 2007 Oct;20(5):476-85. doi: 10.1111/j.1365-277X.2007.00817.x.
It has been consistently observed that a significant proportion of hospital inpatients are malnourished and many actually develop malnutrition in hospital. The NHS provides over 300 million meals each year at a cost of pound 500 million, yet there is relatively little research evaluating how well different catering systems provide for the needs of hospital inpatients.
The aim of the study was to: (i) evaluate whether a new steam meal catering system (Steamplicity) enables patients in theory to meet their energy requirements in hospital and (ii) compare energy and protein intake using Steamplicity with a traditional bulk cook-chill system.
Patients not at nutritional risk had their food intake at one lunchtime assessed. Energy intake was compared with the patients' energy requirements and energy and protein intake were compared with previous data from a bulk system.
Fifty-seven patients had a median daily energy requirement of 7648 kJ (1821 kcal) [inter-quartile range (IQR): 6854-9164 kJ]. Assuming 30% [2293 kJ (546 kcal)] should be supplied by the lunch meal the average intake of 1369 kJ (326 kcal) fell short by 40%. Patients served meals from Steamplicity ate less energy [1369 kJ versus 1562 kJ (326 kcal versus 372 kcal) P = 0.04] but similar protein (18 g versus 19 g P = 0.34) to the bulk system. The largest difference was the energy provided by the dessert since the bulk system served more hot high-calorie desserts.
Patient intakes did not meet their estimated requirements. The patients in this study were eating well and not at nutritional risk, thus patients with a poor appetite will be even less likely to meet their nutritional requirements. Steamplicity meals result in a lower energy intake than meals from a bulk cook-chill system, but similar protein intakes.
一直以来都观察到，相当一部分住院患者存在营养不良的情况，而且许多患者实际上是在住院期间出现了营养不良。英国国家医疗服务体系（NHS）每年提供超过3亿份餐食，花费5亿英镑，但相对而言，评估不同餐饮系统满足住院患者需求程度的研究较少。
本研究的目的是：（i）评估一种新的蒸汽餐餐饮系统（Steamplicity）理论上是否能使患者在住院期间满足其能量需求，以及（ii）将使用Steamplicity系统的能量和蛋白质摄入量与传统批量烹饪 - 冷藏系统进行比较。
对无营养风险的患者在一个午餐时间的食物摄入量进行评估。将能量摄入量与患者的能量需求进行比较，并将能量和蛋白质摄入量与批量系统的先前数据进行比较。
57名患者的每日能量需求中位数为7648千焦（1821千卡）[四分位间距（IQR）：6854 - 9164千焦]。假设午餐应提供30%[2293千焦（546千卡）]的能量，平均摄入量为1369千焦（326千卡），短缺40%。使用Steamplicity系统用餐的患者摄入的能量较少[1369千焦对1562千焦（326千卡对372千卡），P = 0.04]，但与批量系统的蛋白质摄入量相似（18克对19克，P = 0.34）。最大的差异在于甜点提供的能量，因为批量系统提供了更多高热量的热甜点。
患者的摄入量未达到其估计需求。本研究中的患者饮食良好且无营养风险，因此食欲不佳的患者更不太可能满足其营养需求。与批量烹饪 - 冷藏系统的餐食相比，Steamplicity餐食的能量摄入量较低，但蛋白质摄入量相似。
